Erectile Dysfunction (ED) | Impotence Treatment | ED Supplements

Erectile Dysfunction

Author: Dr. Veena

Erectile dysfunction (ED) refers to the inability of men to attain and maintain an erect penis with sufficient rigidity to allow sexual intercourse. It occurs in middle-aged men and is common after the age of 65. Patients need to discuss this matter frankly with their doctor.

Erectile dysfunction, also known as impotence, is characterized by difficulty in maintaining an erection for satisfactory sexual activity. Impotence refers to the state of being impotent, which is an abnormal physical or psychological condition where a male cannot copulate due to the inability to have or maintain an erection. Sometimes, the term impotence is also used for a condition where a man can have an erection but cannot ejaculate semen.

Erectile dysfunction is a complex multi-system disorder with a variety of vascular, neurogenic, hormonal, pharmacological, or psychogenic causes.

Causes: Causes of erectile dysfunction are divided into psychological and physical categories.

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With Reduced Libido:

• Hypogonadism: Functional incompetence of the gonads, especially in males, with subnormal or impaired production of hormones and germ cells.
• Depression

With Intact Libido:

• Psychological problems, including anxiety
• Vascular insufficiency (atheroma)
• Diabetes mellitus
• Alcohol excess
• Multiple sclerosis
• Drugs like β-blockers and diuretics (Thiazide)

If the patient has erections upon waking in the morning, vascular and neuropathic causes are less likely. Stress and strain can also contribute to erectile dysfunction.

A variety of mechanical/prosthetic devices and surgeries have been used for erectile dysfunction, but drug therapy has made a significant impact recently.

Symptoms: Absence of the urge to engage in sex, and failure to achieve an erection.

Herbs Useful for Treating ED:

• Panax Ginseng: Effective for erectile dysfunction, particularly red ginseng, often called "Herbal Viagra." Side effects include insomnia.
• Pinus pinaster: Requires long-term administration. Side effects include mouth ulcers, dizziness, and headache.
• Safed Musli (Chlorophytum arundinaceum): Prescribed for impotence and debility. Acts as a aphrodisiac tonic, refrigerant, and anti-fatigue. It provides strength and vigor (Ref: Wealth Of India, rev Vol 3, 1992,482; Materia Medica based on Ayurveda, Saukhyam of Todarananda, commentary by Vaidya Bhagwan Dash et al., 1980, 50; Indian Herbal Therapies – C.P. Khare).
• Nutmeg (Myristica fragrans): Treats debility and impotence (Ref: Dravyagun Vigyan, Indian Materia Medica).
• Salabmishri (Orchis latifolia): Acts as a vitalizer, nervine, and brain tonic. It is restorative, invigorating, and aphrodisiac, used in diseases related to weakness or sexual powers (Ref: Indian Materia Medica, Charak Samhita).
• Konch (Mucuna prurita seeds): Aphrodisiac, prescribed for impotence (Ref: Dravyagun Vigyan).
• Yohimbe: Found in the bark of an African tree. Studies show promising results for erectile dysfunction, but side effects include kidney failure and heart attack. It should be taken only with a doctor’s prescription.
• Saw Palmetto: Used for erectile dysfunction due to an enlarged prostate. However, clinical trials show it is not effective for dysfunction due to an enlarged prostate.

Consult a doctor before taking these herbs.

Natural Home Remedies

1. Garlic (Allium sativum): Take 2 to 3 crushed garlic cloves with honey three times a day. Garlic acts as a powerful aphrodisiac, increasing hydrogen sulfide production, which helps relax blood vessels. Allicin in garlic stimulates blood flow. Remove the outer layer of garlic, boil 5 to 6 de-skinned cloves in a cup of milk, add sugar, and take twice daily.
2. Papaya (Carica papaya): Advisable as it contains arginine, which is also present in Viagra.
   
3. Black Gram with Onion (Allium cepa) juice: Take once a day.
   
4. Dried Dates: Have aphrodisiac properties.
   
5. Black Raisins: Advisable.
   
6. Herb Mixture: Take a mixture of Bala, Ashwagandha, Vidari, and Safed Musli twice a day with lukewarm milk (for quantity, contact the author).
   
7. Saffron Milk: Add a pinch of saffron to a cup of hot milk and drink before bed.
   
8. Garlic Paste: Crush garlic, make a paste, and add one-fourth of the paste to hot milk. Drink twice a day. Garlic increases blood supply.
   
9. Garlic and Honey: Make a paste of garlic, add honey, and take one teaspoon twice a day.
   
10. Pomegranate Juice: Drink twice daily.
    
11. Herbal Mixture: For psychological issues, mix Shankhapushpi (Convolvulus pluricaulis), Brahmi (Bacopa monnieri), and Jatamansi (Nardostachys jatamansi). Take 1 teaspoon of this mixture in 2 cups of water, boil until reduced by half, filter, and drink once a day.

Use flaxseed oil for cooking. It has been observed that individuals with erectile dysfunction often have low levels of zinc. Foods rich in zinc include dairy products, pumpkin seeds, sunflower seeds, peanuts, and brown rice. Ashwagandha (Withania somnifera) churna (1 teaspoon) taken twice daily with milk is advisable.

L-Arginine: An amino acid found in dairy products and fish that helps expand blood vessels. Side effects include nausea, vomiting, diarrhea, and stomach cramps. Contraindicated for people taking Viagra or blood pressure medication.

Additional Tips

• Give a gap of four days after each intercourse.
• Include ghee in your meals.
• DHEA: A steroid hormone naturally produced by the body, helps in conditions with low testosterone levels, which are rare and unlikely to cause erectile dysfunction. DHEA can produce side effects like acne and reduced HDL (good cholesterol).

What to Do (DO’s)

• Take Abhyanga (bath) with medicinal herbs after consulting an Ayurvedic doctor.
• Proper physical exercise followed by relaxation is advisable.
• Perform certain yoga postures after consulting a yoga teacher.
• Massage the body with Shree Gopal oil (Ayurvedic oil), including the pubic area.

What to Avoid

• Avoid oily and spicy food.
• Prevent indigestion and constipation.
• Avoid working in a stressful atmosphere.
• Avoid exercise before sexual performance.

Partner's Role

A sympathetic partner can help overcome this problem and may increase the confidence level of the person affected by erectile dysfunction.

Granthokta Preparations

• Dhatupoushtic Churna
• Musali Pak
• Ashwagandha Lehyam
• Shilajit Capsule
• Manmath Ras

Though I have mentioned the quantity of ingredients in some natural home remedies, it is advisable to consult an Ayurvedic physician before use.

FAQs on Erectile Dysfunction

1. What is erectile dysfunction, and how common is it?
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse. It is common, especially in men over 65, but can affect middle-aged men as well. It’s a complex condition with various physical and psychological causes.

2. What are the main causes of erectile dysfunction?
ED can stem from psychological factors (e.g., anxiety, depression, stress) or physical issues (e.g., vascular insufficiency, diabetes, alcohol excess, multiple sclerosis, or medications like β-blockers). Low libido may be linked to hypogonadism, while intact libido may point to other causes like vascular or psychological issues.

3. How can I tell if my erectile dysfunction is physical or psychological?
If you experience erections upon waking (nocturnal penile tumescence), it’s less likely to be caused by vascular or neuropathic issues, suggesting psychological factors like stress or anxiety may be the cause. Consulting a doctor for a proper diagnosis is essential.

4. Are there natural remedies for erectile dysfunction?
Yes, natural remedies include:

• Garlic: 2–3 crushed cloves with honey or boiled in milk, taken daily, to improve blood flow.
• Papaya: Contains arginine, which may help with erections.
• Black raisins, dried dates, and pomegranate juice: Known for their aphrodisiac properties.
• Herbal mixtures: Combining herbs like Ashwagandha, Safed Musli, or Shankhapushpi with milk or water. Always consult a doctor before use.

5. Which herbs are effective for treating erectile dysfunction?
Herbs like Panax ginseng (red ginseng), Safed Musli, nutmeg, Konch (Mucuna prurita), and Salabmishri are traditionally used for ED. Yohimbe shows promise but has serious side effects (e.g., kidney failure, heart attack) and requires a doctor’s supervision. Saw palmetto is not effective for ED caused by an enlarged prostate.

6. What lifestyle changes can help with erectile dysfunction?

• Engage in regular physical exercise followed by relaxation.
• Practice yoga postures under guidance.
• Massage with Ayurvedic oils like Shree Gopal oil.
• Include zinc-rich foods (e.g., pumpkin seeds, dairy, brown rice) and flaxseed oil in your diet.
• Avoid oily, spicy foods, stress, and constipation.

7. Are there any side effects of herbal treatments for ED?
Yes, herbs like Panax ginseng may cause insomnia, Pinus pinaster can lead to mouth ulcers or dizziness, and Yohimbe carries risks of severe side effects like kidney failure or heart attack. Always consult a healthcare provider before starting herbal treatments.

8. Can diet improve erectile dysfunction?
Yes, foods rich in zinc (e.g., dairy, peanuts, sunflower seeds) and L-arginine (e.g., fish, dairy) can support blood vessel health and improve ED. Pomegranate juice, black gram with onion juice, and saffron milk are also recommended.

9. What role does a partner play in managing erectile dysfunction?
A supportive partner can boost confidence and help reduce psychological barriers related to ED, improving outcomes through emotional support and open communication.

10. Are there Ayurvedic treatments for erectile dysfunction?
Ayurvedic remedies like Dhatupoushtic Churna, Musali Pak, Ashwagandha Lehyam, Shilajit Capsule, and Manmath Ras are suggested, but should only be used under the guidance of an Ayurvedic physician.

11. Can medications cause erectile dysfunction?
Yes, drugs like β-blockers and thiazide diuretics can contribute to ED. If you suspect medication is affecting you, discuss alternatives with your doctor.

12. Is it safe to use L-Arginine or DHEA for erectile dysfunction?
L-Arginine, found in dairy and fish, may help by expanding blood vessels but can cause nausea, diarrhea, or stomach cramps and is contraindicated with Viagra or blood pressure medications. DHEA may help in rare cases of low testosterone but can cause acne or reduced HDL cholesterol. Consult a doctor before use.

13. When should I see a doctor for erectile dysfunction?
You should consult a doctor if ED persists, as it may indicate underlying conditions like diabetes, vascular issues, or hormonal imbalances. A healthcare provider can recommend safe treatments and rule out serious causes.

14. Can stress or mental health issues cause erectile dysfunction?
Yes, psychological factors like stress, anxiety, and depression can significantly contribute to ED, especially when libido is intact. Addressing these through therapy, relaxation, or herbal mixtures (e.g., Shankhapushpi, Brahmi) may help.

15. Are there any precautions to take when trying home remedies for ED?
Always consult an Ayurvedic physician or doctor before trying home remedies or herbs, as incorrect dosages or interactions with medications can cause side effects. Avoid self-medicating, especially with herbs like Yohimbe, which have serious risks.